Pothuri Bhavana, Muir Michele, Hurteau Jean, Farley John, Lightfoot Michelle D S, Dewdney Summer, Castellano Tara, Chan John K, Ghamande Sharad, Asante-Facey Al, Stasenko Marina, Rimel B J, Paskett Electra D
Perlmutter Cancer Center, NYU Langone, New York, NY, USA.
GSK, Collegeville, PA, USA.
Gynecol Oncol Rep. 2025 Jun 30;60:101799. doi: 10.1016/j.gore.2025.101799. eCollection 2025 Aug.
Significant disparities exist in the care of patients with gynecologic malignancies. Higher incidences of gynecologic malignancies among underrepresented subpopulations (eg, racial, ethnic, and/or LGBTQAI+) and lack of representative enrollment within clinical trials have highlighted the need to improve healthcare equity. We aimed to identify barriers to equitable health care and clinical trial participation for specific diverse populations of patients with gynecologic malignancies and to identify potential solutions for overcoming these barriers.
A series of 4 live and 3 asynchronous advisory boards facilitated by GSK was conducted between January 2023 and July 2024; live advisory boards were population specific. Gynecologic oncologists, health researchers, advanced practice providers, patients, and patient advocacy group representatives who worked with and/or were themselves members of the focus population participated. Insights were compiled and analyzed to identify barriers and potential solutions across and within populations.
Common barriers to equitable health care across all populations included cost, transportation, level of health literacy, and provider biases; 11 population-specific barriers were noted, with LGBTQAI+ patients described as facing the most barriers. Patient navigator involvement was identified as a feasible and highly impactful solution for breaking multiple barriers across various diverse populations.
Most barriers to equitable health care were population specific, affirming the need for continued consultation and discussions with members of communities and with individuals to address specific barriers and enact effective solutions. Engagement of patient navigators was identified as an important way to improve disparities within the care of gynecologic malignancies across all underrepresented patients.
妇科恶性肿瘤患者的护理存在显著差异。在代表性不足的亚人群（如种族、族裔和/或LGBTQAI+群体）中，妇科恶性肿瘤的发病率较高，且临床试验中缺乏代表性入组，这凸显了改善医疗公平性的必要性。我们旨在确定特定不同人群的妇科恶性肿瘤患者在获得公平医疗和参与临床试验方面的障碍，并确定克服这些障碍的潜在解决方案。
2023年1月至2024年7月期间，由葛兰素史克公司主持召开了一系列4次现场和3次非同步咨询委员会会议；现场咨询委员会针对特定人群。与目标人群合作和/或本身就是目标人群成员的妇科肿瘤学家、健康研究人员、高级执业提供者、患者以及患者权益倡导组织代表参与了会议。对见解进行汇总和分析，以确定不同人群之间和人群内部的障碍及潜在解决方案。
所有人群在获得公平医疗方面的常见障碍包括成本、交通、健康素养水平和提供者偏见；共发现11个特定人群障碍，其中LGBTQAI+患者面临的障碍最多。患者导航员的参与被确定为打破不同人群中多种障碍的可行且极具影响力的解决方案。
公平医疗的大多数障碍是特定人群的，这证实了需要继续与社区成员和个人进行协商和讨论，以解决特定障碍并制定有效的解决方案。患者导航员的参与被确定为改善所有代表性不足患者的妇科恶性肿瘤护理差异的重要途径。
